Polyarthralgia

Polyarthralgia is the experience of pain in multiple joints, typically without objective joint inflammation. It is distinguished from polyarthritis, in which joints show inflammatory signs such as swelling, warmth, or redness. Polyarthralgia can be transient or persistent and may reflect benign self-limited processes or an underlying systemic disorder.

Patients commonly report pain in several joints that may be symmetric or asymmetric. Morning stiffness is usually mild and of short duration. The pain can involve small, large, or weight-bearing joints and may be accompanied by fatigue. Red flags include persistent fever, night pain, weight loss, or new joint swelling, which suggest an inflammatory or infectious cause requiring prompt evaluation.

Common etiologies include viral or post-viral arthralgia (notably parvovirus B19), autoimmune or inflammatory diseases (rheumatoid arthritis, systemic lupus erythematosus), post-infectious reactive arthritis, and adverse drug effects (certain antibiotics and statins). Metabolic or endocrine disorders such as hypothyroidism, and fibromyalgia can present with widespread joint pain without classic inflammatory arthritis.

Evaluation starts with a focused history and examination, followed by basic laboratory testing: CBC, ESR/CRP, rheumatoid factor, anti-CCP antibodies, ANA when indicated, and urinalysis. Imaging (X-ray, ultrasound, or MRI) is guided by clinical suspicion. Additional tests are tailored to suspected etiologies.

Management aims to treat underlying causes when identified and to relieve symptoms. Many viral or benign arthralgias resolve without specific therapy. Symptom relief includes analgesics (acetaminophen), NSAIDs, topical agents, and physical therapy. In inflammatory or autoimmune conditions, disease-modifying therapies and specialist referral are indicated. Prognosis varies; many cases improve, but some may progress to chronic inflammatory arthritis.